124 | EYEWORLD | DECEMBER 2020
P
RACTICE MANAGEMENT
The number one mistake Dr. Osher thinks
doctors make when there is a complication is
that they distance themselves from the patient.
"It should be the exact opposite," Dr. Osher
said.
It is the complicated patient who should
receive personal calls to see how they're doing,
the one who should be offered genuine concern
and reassurance.
"This is the patient you want to shower
with attention. … The patient knows I really
care. That goes a long way," he said.
Some of these conversations can also be
made easier if the preoperative discussion is
handled differently.
"For example, if patients who have under-
gone previous refractive surgery are told ahead
of time that they will probably need a thin
pair of glasses following surgery, it becomes an
expectation and not a complication," Dr. Osher
said.
Leaving a patient without
a lens
Dr. Parker thinks this is an important conversa-
tion to prepare for, especially for those early in
their career. When the capsular bag is compro-
mised, surgeons have three options: put the lens
in the bag with a sometimes technically compli-
cated fixation technique; use an AC IOL, which
he said can have problems later; or leave the
patient without a lens.
"Most surgeons don't want to have to ex-
plain to the patient why they didn't put a lens in
… and instead put the worst lens in the worst
location, and it ends up causing problems for
the patient down the line," Dr. Parker said.
Instead, he advised preparing for this type
of conversation ahead of time so the patient
can be referred to a doctor more experienced in
performing the fixation techniques for IOLs in
these situations.
continued from page 123
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